腔内激光联合Trivex 旋切术治疗重度下肢浅静脉曲张的临床效果

目的：探讨腔内激光治疗术联合Trivex旋切术治疗重度下肢浅静脉曲张的临床疗效。 方法：分析2012年7月—2013年10月收治的20例（26条肢体）重度下肢原发性下肢静脉曲张患者临床资料。患者均行腔内激光治疗术联合Trivex旋切术治疗。 结果：全部患者顺利完成手术。术后下肢静脉曲张均消失，色素沉着、瘙痒、湿疹、皮肤溃疡等并发症不同程度的减轻；并发皮下淤斑、局部肿胀4例，均在1个月内消失；1例出现患肢小腿外侧肿胀，穿刺抽吸积液并以弹力绷带加压包扎后肿胀消退；2例出现患肢皮肤麻木，2个月后消失；2例大隐静脉主干部位和曲张静脉烧灼处出现条索状硬结，并伴有局部轻中度疼痛，2~3周症状逐渐消失。术后平均随访8个月，无曲张静脉复发及小腿无明显瘢痕。 结论：腔内激光治疗术联合Trivex旋切术对原发性下肢静脉曲张具有良好的治疗效果治疗，且具有微创及美容效果好等优点。

Endovenous laser therapy combined with transilluminated powered phlebectomy for severe varicose veins of lower limbs

Objective: To assess the clinical efficacy of endovenous laser therapy plus transilluminated powered phlebectomy (Trivex system) in treatment of severe varicose veins of lower limbs. Methods: The clinical data of 20 patients with severe primary varicose veins of the lower extremities (26 legs) treated from July 2012 to October 2013 were retrospectively analyzed. All patients underwent endovenous laser therapy combined with transilluminated powered phlebectomy. Results: Operation was successfully completed in all patients. After operation, the lower extremity varicose veins disappeared, the complications such as pigmentation, itching, eczema and skin ulcer were attenuated in different degrees; 4 cases developed subcutaneous ecchymosis and local swelling which in all cases disappeared within one month and one cases had the lateral crus swelling, which was eliminated by puncture aspiration of fluid and elastic bandage compression; 2 cases had numbness of extremity, which disappeared after 2 months, and in 2 cases funicular callus appeared along the main trunk of the great saphenous vein and the burning sites of varicose veins, accompanied by local mild-to-moderate pain, which gradually disappeared in 2 to 3 weeks. The average postoperative follow-up was 8 months, and no recurrence of varicose veins or evident scars in the legs was noted. Conclusion: Endovenous laser therapy in combination with transilluminated powered phlebectomy is effective in treatment of severe varicose veins of lower limbs, and meanwhile it has minimal invasiveness and better cosmetic results.